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Results suggest that identification of drivers at increased risk of recidivism may be possible at first program attendance by examining indicators of increased alcohol-related problems. In addition, recidivists appear to show a greater readiness to change at second attendance. Implications for remedial program development and recommendations for future research are discussed.

In 1998, Ontario passed legislation requiring that all drivers convicted of drinking and driving complete a remedial program, called Back on Track (BOT), before their driver’s licences could be reinstated. Based on an assessment, clients are assigned to complete either an “education” program or a “treatment” program, depending on levels of substance-related problems. Several months following completion of their program, participants complete a follow-up interview. We report substance use and related outcome measures on 22,277 BOT participants who completed follow-up between 2000 and 2005. Completion of BOT was associated with significant reductions in the frequency of alcohol and other drug use, number of drinks consumed per drinking occasion, total numbers of substance users, and negative consequences resulting from substance use. A large number of participants became “non-users” of various substances over the course of the program. These findings provide evidence that the remedial program has beneficial effects for participants in both the education and treatment components of BOT.

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Brief interventions effectively reduce alcohol problems; however, it is controversial whether longer interventions result in greater improvement. This study aims to determine whether an increase in treatment for people with more severe problems resulted in better outcome. We employed regression-discontinuity analyses to determine if drinking driver clients (n = 22,277) in Ontario benefited when they were assigned to a longer treatment program (8-hour versus 16-hour) based on assessed addiction severity criteria. Assignment to the longer16-hour program was based on two addiction severity measures derived from the Research Institute on Addictions Self-inventory (RIASI) (meeting criteria for assignment based on either the total RIASI score or the score on the recidivism subscale). The main outcome measure was self-reported number of days of alcohol use during the 90 days preceding the six month follow-up interview. We found significant reductions of one or two self-reported drinking days at the point of assignment, depending on the severity criterion used. These data suggest that more intensive treatment for alcohol problems may improve results for individuals with more severe problems.

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